Breast Cancer Screening: 2024 new USPSTF recommendations | Prof Luigi Fontana

Breast cancer ranks as the second most common cancer and the second leading cause of cancer-related deaths. In 2023, approximately 43,170 women died from breast cancer in the United States alone. Non-Hispanic White women exhibit the highest breast cancer incidence rate, with 5-year age-adjusted incidence rates at 136.3 cases per 100,000 women, followed by non-Hispanic Black women at 128.3 cases per 100,000 women.
Alarmingly, incidence rates have seen a gradual increase among women aged 40 to 49 years from 2000 to 2015, followed by a more pronounced increase from 2015 to 2019, averaging a 2.0% annual rise.
Diet and exercise, when prescribed in a personalized and dose-response manner, play a pivotal role in both primary and secondary prevention of breast cancer, particularly when coupled with screening. New recommendations from the US Preventive Services Task Force suggest that biennial screening mammography for women aged 40 to 74 years offers a moderate net benefit. However, evidence remains insufficient to determine the benefits and harms of screening mammography for women aged 75 years and older, even if Breast cancer incidence increases with age and peaks among persons aged 70 to 74 years, although rates in persons 75 years or older remain high (453.3 and 409.9 cases per 100 000 women aged 75 to 79 and 80 to 84 years, respectively, compared with 468.2 cases per 100 000 women aged 70 to 74 years), and mortality from breast cancer increases with increasing age. Notably, no randomized clinical trials of breast cancer screening included women 75 years or older.
Finally, The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or MRI, regardless of breast density.
These updated guidelines mark a significant departure from the 2016 recommendations, which advocated for biennial screening mammography for women aged 50 to 74 years and individualized screening decisions for women aged 40 to 49 years based on risk factors, preferences, and values.
Overall, evidence suggests that biennial screening yields a more favorable benefit-to-harm ratio compared to annual screening. Data from the Breast Cancer Surveillance Consortium indicate no significant difference in detecting advanced stage cancers or less favorable prognosis cancers between annual and biennial screening intervals across all age groups. Moreover, modeling data indicate that biennial screening leads to a more favorable balance of benefits compared to harms.
Potential harms of screening mammography include false-positive results, psychological distress, additional testing, overdiagnosis, overtreatment, and radiation exposure.
It's important to note that these recommendations exclude individuals with high-risk genetic markers or syndromes (BRCA1 or BRCA2 genetic variation), history of high-dose radiation therapy to the chest at a young age, previous breast cancer, or high-risk breast lesions on previous biopsies.

[@jpintero6330]

Thank you!

[@estersegalla2892]

🙏🌷

[@beppeguenzati5774]

can all this increase in breast cancer also be connected to
birth control pill?

[@salvomaddi9081]

Professore per favore in italiano. Grazie